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KMID : 1033120130020020028
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대한비만대사외과학회지
2013 Volume.2 No. 2 p.28 ~ p.32
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Resectional Roux-en-Y Gastric Bypass
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Kim Jin-Jo
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Abstract
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Roux-en-Y gastric bypass is a surgical mainstay among bariatric procedures for morbidly obese patients. Conventional Roux-en-Y gastric bypass consists of creation a small gastric pouch, a long Roux limb usually 1-2 meters long to bypass the absorption area of the small bowel, and leaving the distal gastric remnant in situ. However, there have been concerns about not being able to screen the distal gastric remnant for the development of cancer, especially in an area where the incidence of gastric cancer is very high, although few cases of gastric cancer in the distal gastric remnant have been reported so far. Moreover, gastrointestinal bleeding due to the presence of unknown gastric or duodenal ulcer, gastrogastric fistula, high incidence of marginal ulcer, bacterial proliferation and high incidence of duodenogastric reflux which remains in the stomach for a long time have been noted in the distal gastric remnant. In this review, the clinical meaning of resection of the distal gastric remnant during a Roux-en-Y gastric bypass, in an area where the incidence of gastric cancer is very high like Korea, is discussed through the review of literature. Resectional Roux-en-Y gastric bypass can be a viable option with safety in Korea because Korean upper gastrointestinal surgeons are very well trained in gastrectomy.
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KEYWORD
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Roux-en-Y gastric bypass, Resection, Distal gastric remnant
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